Many nurses are reluctant to assume a Charge Nurse role, since they are often asked to do this without any education or training. Yet charge nurses play a critical role in helping their Nurse Manager or leader achieve desired financial and clinical outcomes. Examples include: staffing, scheduling, assignments, patient placement and throughput.

One key competency that Charge Nurses struggle with is learning how to delegate. Many find it is difficult to delegate tasks to peers, since they rely on peers for assistance with patient care later when not in the Charge Nurse role. Staffing in some organizations require the Charge Nurses to take a patient assignment, while in other hospitals they do not. But delegation is still a key competency Charge Nurses need to exhibit to assure that units run efficiently.

Delegation Framework

Following a delegation framework will help assure that the right task(s) will be assigned to the right staff member, under the best circumstance, and begin to answer issues of communication, supervision, and evaluation needed. Delegation remains an underdeveloped skill among nurses, and one that is difficult to measure - but it can be planned for! The following outlines components of the Rights of Delegation Model:

Assessment and Plan: As a Charge Nurse, am I giving the right tasks to the right nurse/staff member?

What are needs of the patients?

What is the predictability of the patient's response to care?

What cognitive abilities are needed to perform tasks? Which team member has the best competencies to perform?

Communication: Is the Charge Nurse providing communication that puts the unit on the right path?

How will tasks get accomplished?

What needs to be reported?

What are communication expectations in emergency situations?

Supervision and Surveillance: Find the right amount of supervision for the unit

What level of supervision should the Charge Nurse provide to be optimal?

Appropriate delegation assumes that prior to assignment of tasks, the Charge Nurse uses judgment and demonstrates critical thinking to assess the skill, competence, attitude, and experience of staff, as well as patient requirements and circumstances. Delegation paves the way for trust, effective communication, and mutual support which contribute to success of effective nursing teams. So help your Charge Nurses plan for delegation. Planning for delegation is planning for success!

Nursing leadership and nursing management often are used as interchangeable terms, but they refer to two different things. Put simply, nurse leaders help influence a hospital’s high-level strategy, while nurse managers are charged with executing that strategy on a day-to-day basis.

According to HRSA, about one-third of RNs are over age 50, and most nurses in leadership positions are even older. As this segment of the work force begins to retire, it’s a mistake to assume that first-level nurse supervisors and nurse managers will be ready to take over for your facility’s CNO without a deliberate succession plan in place.

The Evolution of Nursing Leaders

The path to nursing leadership has evolved in recent years. In the past, nurses only took on administrative responsibilities once they had proven themselves in a clinical setting — an advanced degree in management was not required. Today, the nursing leadership landscape demands that nurses seek out business expertise in addition to clinical training, including degrees and certifications, if they hope to be promoted to a leadership role. As such, healthcare organizations must be more proactive than ever in steering nursing professionals toward the management track.

Unfortunately, many health systems and hospitals still are deficient in their succession planning efforts, according to the National Healthcare Leadership Index survey conducted by National Center for Healthcare Leadership (NCHL). Only 8 percent of nursing leader respondents reported they received “a great deal”’ of succession planning.

Grooming Leaders From Within

Succession planning should comprise the careful process of identifying and nurturing a pool of internal candidates as emerging leaders. Ideally, current leaders should become mentors to this group, grooming them with intention. The candidates should have easy access to continuing education resources and professional development opportunities, and they should be encouraged to take advantage of them. Aside from valuable institutional knowledge, developing new leaders from within your organization just makes good financial sense — it is much more costly to replace a high-ranking officer from the outside than develop an internal candidate.

According to Medscape, a top characteristic to look for in prospective nurse leaders is the potential to be a “transformational leader.” These people are adept at identifying needed changes, guiding those changes by inspiring others, and instilling a company-wide commitment to make change happen. Transformational leadership has been shown to improve nurse satisfaction at the unit level, promote a positive work environment and reduce turnover. According to AONE, nurse executive leadership competencies should also include foundational thinking skills, personal journey lessons and systems thinking.

Mitigating the Stress of Succession

Because there likely will be a major transition among nursing leadership during the next decade, NCHL offers best practices to minimize and mitigate the trauma of this transition. Effective succession planning should be integral to the hospital’s culture and foster clear communication that stresses succession planning as an organizational priority. NCHL also recommends involvement and ownership in succession planning by senior management; use of a leadership competency model; rigorous assessment of leadership candidates with a focus on retaining them; encouraging those candidates to stretch their skills and perspectives; implementing formal professional development plans that emphasize on-the-job training; and ongoing measurement and evaluation to ensure the succession plan is on track.

In order to assure continuity of nursing leadership, a seamless transition at retirement, minimal financial impact and uninterrupted staff and patient satisfaction, hospitals must be strategic in their succession planning sooner rather than later. Start planning for the future of your facility today.